Dr. Brian J. Druker
Dr. Druker’s research was instrumental in the development and approval of imatinib, which has transformed the management of chronic myeloid leukemia (CML). Imatinib, a tyrosine-kinase inhibitor, received the fastest approval in U.S. Food and Drug Administration history and turned a previously fatal disease into a manageable condition. Approximately 90% of patients with CML who are treated with imatinib are still alive 5 years after starting treatment.
Dr. Druker’s work on imatinib introduced the concept of targeted therapy and laid the foundation for a new direction in oncology—precision medicine—which is focused on a personalized approach to cancer treatment.
Dr. Druker’s revolutionary contributions to oncology have been recognized on numerous occasions: he has received the Warren Alpert Prize, the Lasker-DeBakey Award for Clinical Medical Research, the Albany Medical Center Prize in Medicine and Biomedical Research, and the Japan Prize in Healthcare and Medical Technology. His honorary lecture scheduled for June 4 will focus on lessons learned from the development of imatinib and applications of precision medicine to other cancers.
In an interview with the ASCO Daily News, he reflected on the personal importance of receiving the Science of Oncology Award and Lecture, highlights of his career as a medical oncologist, and his outlook on precision medicine.
ASCO Daily News: What is the relevance of the Science of Oncology Award and Lecture to you on both a personal and professional level?
Dr. Druker: Recognition from my peers and the largest and most influential Society representing oncologists is an incredible honor. I started my career hoping to make a difference in the lives of my patients—I am incredibly grateful to the patients who have gone on this journey with me. It is remarkable how patients put faith in their doctors, and it was this faith that carried me through the most difficult times in my career.
ASCO Daily News: Twenty-five years ago, oncology researchers and pharmaceutical companies were skeptical about the feasibility of cancer treatments that could target cancer cells while leaving healthy cells unharmed. As a pioneer of precision medicine, can you identify a critical turning point in this field?
Dr. Druker: I’ve always believed that there had to be a way to kill cancer cells without harming normal cells, and that the answer would be found through scientific investigations of cancer. My unique position as a physician and researcher working on kinases that regulated cell growth allowed me to bridge these two disciplines by studying CML and BCR-ABL.
ASCO Daily News: What were the key events that led to the discovery of imatinib, and how has it influenced cancer treatment since?
Dr. Druker: Having patients who desperately needed better therapies for their leukemia spurred me to continue to pursue the development of a specific inhibitor of the BCR-ABL tyrosine kinase, even when others were incredibly skeptical that this approach would work. Besides turning CML into a manageable condition, it has been remarkable how this work has inspired targeted cancer drug development and a renewed optimism in oncologists that we can develop more effective and less-toxic therapies.
ASCO Daily News: What are some of your current research interests and goals? In 10 years, what would you like to see your research team accomplish?
Dr. Druker: The remaining challenge in CML is disease eradication, and we continue to investigate ways in which we can change leukemia from controlled to cured. We have also turned our attention to acute myeloid leukemia, which is a much more complicated disease, and in which we believe combinations of targeted therapies will be necessary for durable responses. Lastly, for the past 15 years, I have talked about the two critical elements that allowed imatinib to be successful for CML. One was targeting the right patients with the right drug, and the second was treating early in the course of disease. Our cancer center is now focusing attention on precision early detection, which we define as using knowledge of the molecular origins of cancer to detect cancers earlier, in their most curable stages, while avoiding overdiagnosis and treatment.
ASCO Daily News: As one of the founders of personalized medicine and based on your collaboration with Intel, how do you envision tumor-profiling technology, in combination with computing, affecting cancer treatment?
Dr. Druker: It’s all about data and access to data. Imagine having access to millions of cancer specimens that have been profiled with annotated clinical data that include treatments, responses, and outcomes. This is what we are trying to create with Intel—the ability to aggregate all of these data as efficiently as possible.
ASCO Daily News: What still needs to happen before tumor profiling and personalized therapy become the mainstream approach to cancer treatment?
Dr. Druker: There are many hurdles, including the costs and reimbursement for tumor profiling; standardization of data from different platforms, institutions, and companies; and privacy concerns. All of these are surmountable but require significant efforts.
–Jasenka Piljac Žegarac, PhD